研究跗骨窦切口治疗跟骨骨折的效果  

Study on the Effect of Sinus Tarsus Incision in the Treatment of Calcaneal Fractures

作　　者：林成 林克凤[1] 刘国铭[1] 李建华[1] 高尚君 邱美光[1] 周仕国[1] LIN Cheng;LIN Kefeng;LIU Guoming;LI Jianhua;GAO Shangjun;QIU Meiguang;ZHOU Shiguo(Department of Orthopedics,Provincial College of Clinical Medicine,Fujian Medical University(South Hospital of Fu⁃jian Provincial Hospital),Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院南院)骨科,福建福州350001

出　　处：《中外医疗》2023年第21期66-69,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨在临床中使用跗骨窦切口治疗跟骨骨折的临床效果。方法 随机选取2021年2月—2022年8月来福建省立医院南院治疗的60例跟骨骨折患者,按照手术方法的差异分为两组,即A组和M组,每组30例,跗骨窦切口内固定是A组的治疗方式;跟骨外侧L形切口内固定是M组的治疗方式,对比两组手术时间、术中出血量、下床时间、Bohlers角、Gissans角、并发症、美国足与踝关节协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分。结果 A组的手术时间和下床时间短于M组,差异有统计学意义(P<0.05);术后两组的Bohlers和Gissans角均得到改善,且A组的Bohlers角(30.25±2.31)°和Gissans角(120.31±2.56)°优于M组,差异有统计学意义(t=5.436、5.933,P<0.05)。两组的并发症比较差异无统计学意义(P>0.05)。A组的AOFAS踝-后足评分优良率高于M组,差异有统计学意义(P<0.05)。结论 跗骨窦切口内固定和跟骨外侧L形切口内固定治疗跟骨骨折均有一定疗效,但跗骨窦切口内固定可以缩短手术时间,减少术中出血量,更好地改善Bohlers角和Gissans角及足部功能,有一定的临床意义。Objective To explore the clinical effect of sinus tarsus incision in the treatment of calcaneal fractures.Methods From February 2021 to August 2022,60 patients with calcaneal fractures treated in the South Hospital of Fujian Provincial Hospital were randomly selected and divided into two groups according to the difference of surgical methods,namely group A and group M,with 30 cases in each group.Internal fixation of tarsal sinus incision is the treatment method of group A,the lateral calcaneal L-shaped incision internal fixation was the treatment method of group M.The operation time,intraoperative blood loss,time to get out of bed,Bohlers angle,Gissans angle,complications,and the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score were compared between the two groups.Results The operation time and time to get out of bed in group A were shorter than those in group M,and the differences were statistically significant(P<0.05).The Bohlers and Gissans angles of the two groups were improved after operation,and the Bohlers angle(30.25±2.31)° and Gissans angle(120.31±2.56)° of group A were better than those of group M,and the differences were statistically significant(t=5.436,5.933,P<0.05).There was no statistically significant difference in complications between the two groups(P>0.05).The excellent and good rate of AOFAS ankle-hindfoot score in group A was higher than that in group M,the difference was statistically significant(P<0.05).Conclusion Internal fixation through tarsal sinus incision and lateral calcaneal L-shaped incision have certain curative effects in the treatment of calcaneal fractures,but internal fixation through tarsal sinus incision can shorten the operation time,reduce intraoperative blood loss,and better improve the Bohlers angle,Gissans angle and foot function.Therefore,internal fixation through tarsal sinus incision has certain clinical significance.

关 键 词：跟骨骨折 跗骨窦切口 骨折内固定术 微创手术 

分 类 号：R687.3[医药卫生—骨科学]